A 12-year-old recently began bedwetting after parental divorce. The physical exam is unremarkable. What should the nurse do next?

Choice A rationale Immediately initiating urological testing without first assessing for psychological factors is premature. While organic causes of enuresis exist, a sudden onset in a 12-year-old following a significant stressor like parental divorce strongly suggests a psychological etiology. Unnecessary invasive testing can be distressing for the child. Choice B rationale Punishing a child for bedwetting is detrimental and ineffective. Enuresis, especially stress-induced, is an involuntary act; punishment increases anxiety and shame, exacerbating the problem rather than resolving it. This approach can damage the child's self-esteem and the parent-child relationship. Choice C rationale Informing the child they are too old for bedwetting shames them and ignores the underlying emotional distress. This approach fosters guilt and inadequacy, reinforcing negative self-perceptions rather than addressing the root cause. Empathy and support are crucial for managing stress-related symptoms. Choice D rationale Providing emotional support and assessing for enuresis as a stress response is the most appropriate initial intervention. The sudden onset of bedwetting after parental divorce strongly suggests a psychological component. Addressing the emotional impact and providing coping strategies can alleviate the stress, leading to resolution of the enuresis.